10 Things I Knew Before Starting Nursing School
Looking back on my journey, I've compiled a list of things that I wish someone had told me prior to starting nursing school. Though now that I think about it, even if I had known these things... I still wouldn't have been prepared. But I hope that it helps at least one of you! Here we go:
1. Nursing school prepares you to pass the NCLEX, not to become a good nurse.
Let's be real here. Schools pride themselves on their NCLEX pass rates and retention rates. They don't seek out graduates 5 years down the line and conduct a study to analyze how successful each student was in the start of their nursing career. With this said, you will learn how to be a good nurse - but in the most standardized way possible. Why? It's impossible to cater to every single student's prospective specialty interest. We are taught priority interventions for each general specialty (medsurg, ICU, psych, peds, OB, geriatrics), counterindications of medications, nursing interventions, nursing diagnoses, and how to write care plans. But we can't possible learn how to juggle 2 laboring patients at a time, while also calling physicians, the OR, charting, talking to the pharmacy, communicating confidently, depending on your coworkers, and asking managers for help, without actual experience.
Don't let this discourage you - it is necessary in the logistical sense. We need to take and pass boards to prove that we are proficient to obtain jobs and care for patients. Instead, seek out ways that you can learn how to be a good nurse: talk to your professors, your nurses, read books, read blogs. You cannot leave campus and think that your learning is done.
2. Nothing is ever concrete.
If you're in nursing school, there's a 99% chance you are in some way a perfectionist or Type A, and I know it pains you to read this. You thrive on routine and organization, but in nursing school, schedules are fluid and this means you have to be flexible. Class may be cancelled due to inclement weather and be switched to a Skype conference last minute. Your preceptor may get the flu and call out sick, causing you to miss out on hours this week. You may be assigned a less-than-average nurse to shadow. But in any unexpected situation, there is something to learn. Being flexible and letting go of the reins is the only way that you can stay sane in nursing school.
Learn what you can control: having your notes ready and printed out so that you're not caught off guard, having your laptop charged, having flashcards or your textbook to review during downtime, and having a positive mindset that allows you to see the good in all situations.
3. You're going to be expected to know everything... but you can't.
Instead, know where you can find the information so that when your professor/mentor/advisor/nurse/doctor asks you a question, you don't say, "I don't know." When you are aware of your resources, you can say, "I know where I can find that information." It is not your job to know every single out of range electrolyte and every single side effect of every single drug. Yes, you need to know a basis of information and be able to critically think to notice when a patients' lytes don't reflect the clinical picture, but it would be impossible for you to know the details of the pathophysiology of every disease/side effect/presentation.
4. A 4.0 should not be your goal.
Say it with me. "A 4.0 should not be my goal." I encourage you to write this in your journal, whiteboard, say it to your friends/family, proclaim it from the mountain tops, whatever. But remember it. You are not your GPA, you are not your exam scores, and you are not your ability to take a standardized test. A 4.0 does not reflect your ability to care for others, advocate for your patients, and empathize. Don't get me wrong - I think that you should always strive to do your best and challenge yourself. I'm not saying that you should set lower standards for yourself by any means.
I mean that if a 4.0 GPA is your goal, your focus will shift to "How can I ace this exam?" rather than "How can I best care for this patient?" and "What is my priority intervention?" Don't let it consume you to the point that you can only pass exams via brute memorization and you dump the info the second you step out of your exam.
5. Some people are just crazy smart. Who cares? (I know you do, because I do, too.)
This is related to the last point about your GPA. Some of your peers will make 100s on the hardest exams and it will baffle you because... how!? I still don't know how some people do it, but it's honestly none of my business. It's been a lifelong journey not to compare myself to others, but in nursing school, its been extremely heightened and challenged. I would study for days and barely make a B, while someone else would work a night shift, come take the exam, and ace it. You have to accept that you have your own strengths and weaknesses. You have to learn how to take any downfalls and learn from them so you can do better next time. You have to learn how to move on. There is nothing more you can do about a bad grade, and it certainly doesn't help comparing yourself to others.
6. You need to network and cultivate relationships.
I've said it once and I'll say it again: you need friends and supporters who understand how demanding these couple of years will be. You family and significant other will not understand completely because they aren't in your shoes, no matter how supportive and encouraging they may be. You also need to talk to your professors and faculty and create relationships with them. I have so many students who message me because they don't know what all they need to do to get that first RN job, how to interview, who to get recommendations from, etc. I encourage you to go talk to your professor during office hours, make sure they know who you are and what you stand for!
Here are a couple reasons why this is important:
- At the end of the term, you end up with an 89.9 average, and you institution does not round. If a professor knows how hard you worked, how you may have missed an assignment because of something you didn't have control over, or how much this class means to you, there may be some leeway. You could get some extra assignments, an opportunity to do make up work, or review a test, etc. Compare this to your professor not knowing you who are or having never spoken to you. Why should they help you if you haven't helped yourself?
- Professors are usually the ones to write letters of recommendations for your jobs, grad school applications, scholarships, etc. They can write up a template and fill in the blanks if they've never gotten to know you, but the difference between a standardized letter of recommendation and one that is backed with recall of the conversations you may have had, or knowledge of your hard work and backstory is profound.
- Your professors and faculty have been nurses. They have friends in every specialty, every department. They are your network. I have known so many students been connected with department managers or a nurse on the unit through the faculty. With this being said, this is also why you should always be "on your best behavior!" I know that sounds weird, but I like to think every opportunity that I have meeting with a professor or instructor a mini interview. Because they will remember that you worked hard, that you asked for help, and that you didn't just do the bare minimum.
- With that said, your faculty has nursing experience. They can help you see different perspectives, give you advice on how to be successful at work, and be mentor/role model. When you connect with multiple faculty, you can take bits and pieces of everyone's experiences and lessons and create your own.
7. No one really knows what you’re going through.
And this was something that was really hard for me to grasp. Trying to talk to my boyfriend, non-nursing friends, and family was almost impossible. No one really understands what we go through or even exactly what nurses do. But despite how discouraging this can be, it can also be encouraging in the fact that you can find friends in nursing school who do understand what you’re going through! Finding this support system is everything.
8. There are so many things you can do as a nurse.
You can stay at the bedside and obtain a whole bunch of certifications! You can also work in primary care and work in clinics. You can do telephone triage. You can climb up that ladder and become a preceptor, team leader, relief charge nurse, charge nurse, supervisor, operations manager. You can also work in case management as an RN. You can work in QI and do chart reviews. You can work in law as an expert witness. You can be a corporate nurse. It’s true when they say that you can do almost anything as a nurse. Dream big!
9. Your dreams may change.
Adding on to #8, I think this is the biggest thing I saw in nursing school. If you guys are familiar with my story, you know that I went into nursing school wanting to pursue women’s health, specifically Labor & Delivery and when I went through nursing school, I held tight to this. But I was still challenged when I loved the Palliate Care portion in my High Acuity rotation with Oncology patients and I loved the ICU. I was scared because I wasn’t ready to have my dreams change because I’m the type of person to decide on one thing and stick to it. But I eventually had to decide what I loved most, and that indeed was L&D. However, I know a bunch of people who went into nursing school adamant that they would never pursue x y and z or even enjoy those rotations. And those people are working in those units today because dreams change!
10. You won’t feel fully confident when you graduate.
And that’s OK! No one comes out of nursing school ready to conquer their new job as an RN. You know why? Because clinicals only gave us a sneak peek at real patient care and time management and delegation. You will become more comfortable with the skills we barely practice in skills lab and SBAR while you train on the job.
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I hope this helps! These are all my own opinions and what I've learned. With all of this said, keep an open mind and enjoy the journey. It's so hard and you'll cry a lot, but it is so, so rewarding and beautiful.
xo,
Clara